本文選題：嬰幼兒重癥毛細(xì)支氣管炎 + 多巴胺�。� 參考：《重慶醫(yī)學(xué)》2017年20期

【摘要】：目的探討多巴胺、酚妥拉明、重組干擾素α聯(lián)合經(jīng)鼻持續(xù)氣道正壓通氣(NCPAP)治療嬰幼兒重癥毛細(xì)支氣管炎的臨床效果。方法嬰幼兒重癥毛細(xì)支氣管炎患兒分為觀察組55例和對照組40例,對照組患兒給予多巴胺、酚妥拉明、重組干擾素α聯(lián)合方案治療,觀察組患兒在此基礎(chǔ)上加用NCPAP,比較兩組治療效果。結(jié)果觀察組患兒總有效率顯著高于對照組,患兒體溫恢復(fù)時(shí)間、憋喘消失時(shí)間、咳嗽停止時(shí)間、肺部哮鳴音消失時(shí)間、住院時(shí)間顯著低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患兒治療后呼吸頻率、心率、PaCO_2水平顯著低于治療前,PaO_2、PaO_2/FiO_2、pH水平顯著高于治療前,差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組患兒治療后呼吸頻率、心率、PaCO_2水平顯著低于對照組,PaO_2、PaO_2/FiO_2、pH水平顯著高于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患兒治療后血清白細(xì)胞介素-8(IL-8)、可溶性血管細(xì)胞間黏附分子-1(sVCAM-1)及尿白三烯E4(LTE4)水平均顯著低于治療前,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患兒治療后血清IL-8、sVCAM-1及尿LTE4水平對比,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患兒復(fù)發(fā)率和病死率顯著低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療期間不良情況發(fā)生率對比,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論多巴胺、酚妥拉明、重組干擾素α聯(lián)合NCPAP治療嬰幼兒重癥毛細(xì)支氣管炎臨床效果顯著,可有效改善患兒血?dú)夥治鲋笜?biāo),縮短癥狀體征緩解時(shí)間,降低復(fù)發(fā)率和病死率,臨床應(yīng)用價(jià)值較高。
[Abstract]:Objective to investigate the clinical effect of dopamine, phentol Lemine and recombinant interferon 偽 combined with nasal continuous positive airway pressure ventilation (NCPAP) in the treatment of severe bronchiolitis in infants. Methods Children with severe bronchiolitis were divided into observation group (n = 55) and control group (n = 40). The observation group was treated with NCPAP on this basis, and the therapeutic effect was compared between the two groups. Results the total effective rate in the observation group was significantly higher than that in the control group. The recovery time of body temperature, the time of disappearing of asthma, the time of stopping cough, the time of disappearance of lung wheezing and the time of hospitalization were significantly lower in the observation group than in the control group, and the difference was statistically significant (P 0.05). The respiratory frequency, heart rate and Paco _ 2 level in the two groups were significantly lower than those before treatment, and the pH level of the two groups was significantly higher than that before treatment (P 0.05), and the respiratory frequency of the observation group was significantly higher than that of the control group. The level of Paco _ 2 in heart rate and Paco _ 2 was significantly lower than that in the control group (P < 0.05), and the pH value of Paco _ 2 / FiO _ 2 was significantly higher than that of the control group (P < 0.05). After treatment, the levels of serum interleukin-8 (IL-8), soluble vascular adhesion molecule-1 (VCAM-1) and urinary leukotriene E4 (LTE4) were significantly lower than those before treatment (P 0.05), and the levels of serum IL-8 sVCAM-1 and urinary LTE4 were significantly lower than those before treatment. The difference was not statistically significant (P 0.05). The recurrence rate and fatality rate in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P 0.05). Conclusion the clinical effect of dopamine, phentol Lemine, recombinant interferon 偽 and NCPAP in the treatment of infant severe bronchiolitis is remarkable. It can effectively improve the blood gas analysis index, shorten the remission time of symptoms and signs, and reduce the recurrence rate and mortality. The clinical application value is high.
【作者單位】： 河北省衡水市哈里遜國際和平醫(yī)院嬰幼兒科;
【分類號】：R725.6

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